suip BY_| Charge To Date Wanted Our Order No,
PLP.

KANSAS CITY [2 yy sac

ORDER BLANK

FORM NO. 194

FGT. Customer’s Order No.

CHECK ONE| Ship To

OWE & CaMPBELL a Date Received

ATHLETIC GOODS Co. / City
1509-11-13 BALTIMORE AVE., KANSAS City, Mo. | ©-9-D- ‘ fit.

STOCK PRICE PLEASE DO NOT USE
a| 32 ARTICLE—EXACT COLOR SHADE—SIZE

NO. EXTENSION THESE COLUMNS

S.

ee

QUOTED PRICES ARE SUBJECT TO ACCEPTANCE BY OFFICE

TRANSPORTATION & eudenee set
A ) INSURANCE CHARGES

Total Amount Remitted $
£ % | Ordered
ORDER PLACED ON 193 By ACKNOWLEDGED

BY
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PLACED AT. - Rees , . Approved

‘ By ;

SHIPPED FROM